Does Tort Reform Affect Doctor Supply?

Tort reform advocates frequently claim physician supply is a tort reform issue. Proponents claim that unless there is reform physicians will flee the state. As an Illinois injury claim lawyer who accepts medical malpractice claims I believe this is relevant to Illinois law because lawmakers here have tried to cap damages in Illinois medical malpractice claims three times. The Illinois Supreme Court has held these caps unconstitutional each time.

In a recent article entitled “Does Tort Reform Affect Physicians Supply – Evidence from Texas“, David Hymen, Charles Silver and Bernard Black examine the question. David Hymen is from University of Illinois, School of Medicine and Law. Charles Silver is from the University of Texas, School of Law.

The authors chose Texas because it adopted fairly strict reforms in 2003. Texas capped non-economic damages against physicians to $250,000.00 with no adjustment for inflation. There is also a cap of $250,000.00 applies to each hospital with a total cap of $500,000.00 for non-economic damages. Lawsuits dropped significantly. Payouts dropped 70%. The authors felt that any physician increase or reduction should be apparent by now.

The authors found no decrease or increase by per capita physicians in Texas. On the contrary, the rate of increase in physicians was lower after reform. The authors believe that physician supply is affected primarily by other factors than tort law. The authors examined “high risk” areas like neurosurgery and came to the similar conclusions.

The authors criticized claims of tort reform proponents that before reform doctors were leaving the state and that they were returning in droves after reform. The proponents had made claims that since reform Texas had set new records for the number of applicants for medical license. Some claimed Texas had doubled the number of doctors it would have licensed in a similar time period without reform. Governor Rich Perry claimed that following tort reform the numbers of doctors increased by 60%. The authors examined the number of physicians in Texas and concluded that the claims of tort reform proponents were false. In fact, the report indicates that tort reform proponents made statements that were “not just garden variety false, but ‘liar, liar, pants on fire’ false.”

Interestingly, the paper found that the rate of increase in physician growth was slower after reform. Many, if not most doctors, choose their residence for reasons other than tort reform. For instance, after Katrina many Louisiana residents relocated to Texas. The Texas Department of State Health Services indicates that an increase in doctors was due in part to Hurricane Katrina. Unless tort reform caused Hurricane Katrina, it should not get credit for such doctor relocation decisions.

Most likely, doctors choose their homes the way other people do. Many want to live by families. Many wish to choose a climate they like. The paper provides more evidence that tort reform does not work the way its proponents claim. What the authors do not address is the unfairness that results to victims of caps on damages.